Dentist Red Bluff Appointment Request

Need an appointment with a dentist in Red Bluff? Requesting an appointment at our Red Bluff, CA family and cosmetic dental office is now easier than ever. Fill out the form below and we'll contact you to find a time that fits your schedule. Start your journey towards a beautiful smile with Dr. Randal Elloway today!


Click Here for New Patient Registration & Health Forms!

Click Here for Patient Consent Forms!

Click Here for Dental Coverage Information Form!

Click Here for Appointment Guidelines Form!

Patient Information (* denotes fields that are required)
Patient Name*
Phone Number*
Email Address
Are you a current patient?
No Yes
Best time(s) to call?
Morning Noon Afternoon Evening
Appointment Information
Preferred Appt Date
Preferred Appt Time
Describe the nature of your appointment or any other comments